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Li X, Zhuang S, He L, Wang S, Zhao M, Lyu X. Brain Abscess Caused by Nocardia brevicatena in an Immunocompetent Patient: A Case Report. Infect Drug Resist 2022; 15:7693-7697. [PMID: 36597454 PMCID: PMC9805727 DOI: 10.2147/idr.s396085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
Nocardia brain abscess is relatively rare and generally occurs in immunodeficient patients. Here, we present the first case of brain abscess due to Nocardia brevicatena in an immunocompetent patient, with unknown origin. In this case, a 49-year-old man was admitted to our hospital with limb twitching and complained of a history of intermittent headache. He was diagnosed with brain abscess through brain imaging and cured after craniotomy for abscess excision and targeted antibiotic treatment. Surgical specimens were sent for further detection. The causative organism was identified by weak acid-fast staining, culture and metagenomic next-generation sequencing (mNGS). We hope this case could provide a reference for incoming patients as well as their clinical management.
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Affiliation(s)
- Xiaoxu Li
- Department of Neurosurgery, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China
| | - Shifang Zhuang
- Genskey Medical Technology Co., Ltd, Beijing, People’s Republic of China
| | - Lin He
- Genskey Medical Technology Co., Ltd, Beijing, People’s Republic of China
| | - Shanmei Wang
- Department of Clinical Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Ming Zhao
- Department of Neurosurgery, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China
| | - Xiaodong Lyu
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China,Correspondence: Xiaodong Lyu, Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450000, People’s Republic of China, Tel/Fax +8613523417973, Email
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Gupta N, Kumar R, Banerjee S, Singh G, Malla S, Ray Y, Ramteke P, George N, Kodan P, Aggarwal A, Kumar P, Jorwal P, Soneja M, Biswas A. Brain abscess in patients with chronic kidney disease: A case-based approach to management in resource-limited settings. Drug Discov Ther 2020; 14:93-97. [PMID: 32321877 DOI: 10.5582/ddt.2019.01062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The management of patients with brain abscess poses a significant challenge to clinicians in patients with chronic kidney disease. Obtaining a biopsy sample from the affected area is the mainstay in the diagnosis, but it is often unavailable. In most cases, therapy is guided by clinical findings and imaging alone. We discuss three cases of brain abscess- each with a different scenario and discuss the issues faced in management. The first case was a 32-year-old post-renal transplant male patient with a brain abscess due to dematiaceous fungi and was treated with amphotericin. The second case was a 42-year-old female patient with stage 5 chronic kidney disease on maintenance hemodialysis who presented with a brain abscess due to suspected fungal infection based on imaging findings and was managed with antibiotics and voriconazole. The third case was a 42-year-old post-renal transplant male patient who presented with a brain abscess due to nocardiosis and was managed with cotrimoxazole, meropenem and linezolid. We also summarize the approach to the management of brain abscess in resource-limited settings.
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Affiliation(s)
- Nitin Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sayantan Banerjee
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gagandeep Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sundeep Malla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Yogiraj Ray
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Ramteke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Netto George
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Parul Kodan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anivita Aggarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pankaj Jorwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashutosh Biswas
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Jiang DZ, Zhou DY, Wu WQ, Wu GY, Quan H. Value of multi-b value DWI in the assessment of early cerebral changes in asymptomatic HIV-positive adolescents. Acta Radiol 2017; 58:867-875. [PMID: 27733641 DOI: 10.1177/0284185116673123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Magnetic resonance imaging (MRI) and functional MRI techniques have been widely used in the diagnosis of human immunodeficiency virus (HIV) infection related diseases. Purpose To explore whether magnetic resonance diffusion-weighted imaging (DWI) can track water molecular diffusion changes in the brain of asymptomatic HIV-positive adolescents. Material and Methods Multi-b value DWI was performed in 23 adolescents, including 15 HIV-positive participants and eight HIV-negative healthy participants. Mean apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (ADCs) values, fast apparent diffusion coefficient (ADCf) values, distribution diffusion coefficient (DDC) values, and heterogeneity index (α) values were calculated within regions of interest (ROIs) in the frontal lobes, basal ganglia, and temporal lobe. Non-parametric tests were then performed. Results In the bilateral frontal lobes, the mean α values in HIV-positive participants were significantly increased compared with those in healthy participants (right side P = 0.001; left side P = 0.000). In the left frontal lobe, the mean DDC value in HIV-positive participants was significantly increased compared with that in healthy participants ( P = 0.008). In the bilateral frontal lobes, the mean ADCf values in HIV-positive participants were significantly lower than those in healthy participants (right side P = 0.011; left side P = 0.008). In the left basal ganglia, the mean α values in HIV-positive participants were significantly lower than that in healthy participants ( P = 0.013). Conclusion Multi-b value DWI could reflect the early characteristics of water molecule diffusion in HIV infections.
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Affiliation(s)
- Da-Zhen Jiang
- Key Laboratory of Artificial Micro- & Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, PR China
| | - Ding-Yi Zhou
- Key Laboratory of Artificial Micro- & Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, PR China
| | - Wei-Qing Wu
- Key Laboratory of Artificial Micro- & Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, PR China
| | - Guang-Yao Wu
- Medical Imaging department of the Zhongnan Hospital of Wuhan University, Wuhan, PR China
| | - Hong Quan
- Key Laboratory of Artificial Micro- & Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, PR China
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Crasto SG, Soffietti R, Rudà R, Cassoni P, Ducati A, Davini O, De Lucchi R, Rizzo L. Diffusion-Weighted Magnetic Resonance Imaging and ADC Maps in the Diagnosis of Intracranial Cystic or Necrotic Lesions. Neuroradiol J 2016; 20:666-75. [DOI: 10.1177/197140090702000611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Accepted: 07/17/2007] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the usefulness of diffusion-weighted (DW) magnetic resonance imaging (MRI) and ADC maps in the differential diagnosis of brain abscesses from cystic or necrotic neoplasms. MR images of 49 patients with 54 lesions were examined retrospectively. All patients underwent conventional MRI and DWI, and ADC values were calculated by placing ROIs of 30 mm2 manually over the cystic part of the lesions. On DWI, all cystic portions of abscesses were hyperintense. Mean ADC values were 0.48×10 mm2/s (range 0.41–0.54×10 mm/s) for pyogenic abscesses, 0.73×10 mm2/s (range 0.65–0.91×10 mm/s) for mycotic abscesses and 0.6 mm2/s for Nocardia abscess. Cystic areas appeared hypointense on DWI in 33/44 tumours (mean value ADC 1.96 mm2/s). Eleven tumours (11/44) appeared hyperintense on DWI: eight metastases from lung cancer (mean ADC value 0.86 mm2/s, range 0.75–1.2 mm2/s), two GBMs (mean 0.7 mm2/s, range 0.67–0.76 mm2/s) and one anaplastic astrocytoma (ADC value 1.24 mm2/s). ADC values may help in differentiating pyogenic abscess from brain tumors or metastatic lesions.
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Affiliation(s)
- S. Greco Crasto
- Department of Radiology, San Giovanni Battista Hospital; Turin, Italy
| | - R. Soffietti
- Division of Neurooncology, University of Turin; Italy
| | - R. Rudà
- Division of Neurooncology, University of Turin; Italy
| | - P. Cassoni
- Department of Biomedical Sciences and Human Oncology, University of Turin; Italy
| | - A. Ducati
- Neurosurgery, Department of Neurosciences, University of Turin; Italy
| | - O. Davini
- Department of Radiology, San Giovanni Battista Hospital; Turin, Italy
| | - R. De Lucchi
- Department of Radiology, San Giovanni Battista Hospital; Turin, Italy
| | - L. Rizzo
- Department of Radiology, San Luigi Gonzaga, Orbassano, University of Turin; Italy
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Jiang DZ, Zhong Y, Zhou DY, Wu WQ, Wu GY, Quan H. Application of brain multi-b-value diffusion-weighted imaging (DWI) in adolescent orphans from AIDS families. Br J Radiol 2016; 89:20150732. [PMID: 26892165 DOI: 10.1259/bjr.20150732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the application value of multi-b-value diffusion-weighted imaging (DWI) with mono-exponential model and stretched-exponential model in the diagnosis of HIV-positive patients. METHODS Multi-b-value (0, 50, 150, 200, 400, 600, 800 s mm(-2)) DWI was performed in 23 adolescent orphans from AIDS families, including 15 HIV-positive subjects and 8 HIV-negative healthy subjects. Apparent diffusion coefficient (ADC) values were fitted by mono-exponential model; distribution diffusion coefficient (DDC) values and heterogeneity index (α) values were fitted by stretched-exponential model in bilateral basal ganglia, then non-parametric tests were performed. RESULTS The signal intensity attenuation in multi-b-value DWI could be well described by both mono-exponential model and stretched-exponential model. In the left basal ganglia, mean α-values in HIV-positive subjects (α = 0.848 ± 0.068) were significantly lower than that in healthy subjects (α = 0.923 ± 0.050, p = 0.013). There was no statistical difference of α-values between HIV-positive subjects and healthy control subjects in the right basal ganglia. Apart from these, there were also no statistical differences of DDC values or ADC values between two groups in bilateral basal ganglia (all p > 0.05). In bilateral basal ganglia, DDC values were positively correlated with ADC values in HIV-positive patients (right basal ganglia: r = 0.832, p = 0.000; left basal ganglia: r = 0.770, p = 0.001) as well as in healthy cases (right basal ganglia: r = 0.927, p = 0.001; left basal ganglia: r = 0.878, p = 0.004). Receiver operating characteristic (ROC) curve analysis yielded area under the ROC curve (Az) values of 0.817 (p = 0.014 < 0.05) in the left basal ganglia. The sensitivity and specificity were 62.5% and 86.7%, respectively. CONCLUSION Through the study of asymptomatic HIV-positive subjects when b < 1000 s mm(-2), we can see stretched-exponential model DWI can provide more information than mono-exponential model DWI. ADVANCES IN KNOWLEDGE Multi-b-value DWI was performed in subjects with HIV. DWI measurements could be neuroimaging biomarkers of cerebral injury in the course of HIV infection.
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Affiliation(s)
- Da-Zhen Jiang
- 1 Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, China
| | - Yang Zhong
- 1 Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, China
| | - Ding-Yi Zhou
- 1 Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, China
| | - Wei-Qing Wu
- 1 Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, China
| | - Guang-Yao Wu
- 2 Medical Imaging Department of the Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Hong Quan
- 1 Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, School of Physics and Technology, Wuhan University, Wuhan, China
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Kim S, Lee KL, Lee DM, Jeong JH, Moon SM, Seo YH, Yoo CJ, Yang D, Cho YK, Park YS. Nocardia brain abscess in an immunocompetent patient. Infect Chemother 2014; 46:45-9. [PMID: 24693470 PMCID: PMC3970313 DOI: 10.3947/ic.2014.46.1.45] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/16/2013] [Accepted: 08/16/2013] [Indexed: 11/24/2022] Open
Abstract
Nocardia cerebral abscess is rare, constituting approximately 1-2% of all cerebral abscesses. Mortality for a cerebral abscess of Nocardia is three times higher than that of other bacterial cerebral abscesses, therefore, early diagnosis and therapy is important. Nocardia cerebral abscess is generally occur among immunocompromised patients, and critical infection in immunocompetent patients is extremely rare. We report on a case of a brain abscess by Nocardia farcinica in an immunocompetent patient who received treatment with surgery and antibiotics. This is the second case of a brain abscess caused by N. farcinica in an immunocompetent patient in Korea.
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Affiliation(s)
- Suyoung Kim
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Kang Lock Lee
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Dong Min Lee
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Ji Hun Jeong
- Department of Laboratory Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Song Mi Moon
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Yiel-Hae Seo
- Department of Laboratory Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Chan Jong Yoo
- Department of Neurosurgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Dongki Yang
- Department of Physiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Yong Kyun Cho
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Yoon Soo Park
- Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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Anagnostou T, Arvanitis M, Kourkoumpetis TK, Desalermos A, Carneiro HA, Mylonakis E. Nocardiosis of the central nervous system: experience from a general hospital and review of 84 cases from the literature. Medicine (Baltimore) 2014; 93:19-32. [PMID: 24378740 PMCID: PMC4616325 DOI: 10.1097/md.0000000000000012] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Central nervous system (CNS) nocardiosis is a rare disease entity caused by the filamentous bacteria Nocardia species. We present a case series of 5 patients from our hospital and a review of the cases of CNS nocardiosis reported in the literature from January 2000 to December 2011. Our results indicate that CNS nocardiosis can occur in both immunocompromised and immunocompetent individuals and can be the result of prior pulmonary infection or can exist on its own. The most common predisposing factors are corticosteroid use (54% of patients) and organ transplantation (25%). Presentation of the disease is widely variable, and available diagnostic tests are far from perfect, often leading to delayed detection and initiation of treatment. The optimal therapeutic approach is still undetermined and depends on speciation, but lower mortality and relapse rates have been reported with a combination of targeted antimicrobial treatment including trimethoprim/sulfomethoxazole (TMP-SMX) for more than 6 months and neurosurgical intervention.
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Affiliation(s)
- Theodora Anagnostou
- From Department of Medicine, Infectious Disease Division (TA, TKK, AD, HAC, EM), Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, and Department of Medicine, Infectious Disease Division (TA, MA, EM), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Frank M, Woschnagg H, Mölzer G, Finsterer J. Cerebellar nocardiosis and myopathy from long-term corticosteroids for idiopathic thrombocytopenia. Yonsei Med J 2010; 51:131-7. [PMID: 20046527 PMCID: PMC2799960 DOI: 10.3349/ymj.2010.51.1.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 05/09/2008] [Accepted: 05/14/2008] [Indexed: 11/30/2022] Open
Abstract
Infection of the central nervous system with Nocardia sp. usually manifests as supratentorial abscesses. Supratentorial and cerebellar abscesses from infection with Nocardia sp. following immunosuppression with long-term corticosteroids for idiopathic thrombocytopenia (ITP) have not been reported. An 83 years-old, human immunodeficiency virus (HIV)-negative, polymorbid male with ITP for which he required corticosteroids since age 53 years developed tiredness, dyspnoea, hemoptysis, abdominal pain, and progressive gait disturbance. Imaging studies of the lung revealed an enhancing tumour in the right upper lobe with central and peripheral necrosis, multiple irregularly contoured hyperdensities over both lungs, and right-sided pleural effusions. Sputum culture grew Nocardia sp. Neurological diagnostic work-up revealed dysarthria, dysphagia, ptosis, hypoacusis, tremor, dysdiadochokinesia, proximal weakness of the lower limbs, diffuse wasting, and stocking-type sensory disturbances. The neurological deficits were attributed to an abscess in the upper cerebellar vermis, myopathy from corticosteroids, and polyneuropathy. Meropenem for 37 days and trimethoprime-sulfamethoxazole for 3 months resulted in a reduction of the pulmonary, but not the cerebral lesions. Therefore, sultamicillin was begun, but without success. Long-term therapy with corticosteroids for ITP may induce not only steroid myopathy but also immune-incompetence with the development of pulmonary and cerebral nocardiosis. Cerebral nocardiosis may not sufficiently respond to long-term antibiotic therapy why switching to alternative antibiotics or surgery may be necessary.
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Abcès cérébraux à Nocardia : caractéristiques radiocliniques et prise en charge thérapeutique. Rev Neurol (Paris) 2009; 165:52-62. [DOI: 10.1016/j.neurol.2008.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 06/05/2008] [Accepted: 06/20/2008] [Indexed: 11/24/2022]
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Kapsalaki EZ, Gotsis ED, Fountas KN. The role of proton magnetic resonance spectroscopy in the diagnosis and categorization of cerebral abscesses. Neurosurg Focus 2008; 24:E7. [DOI: 10.3171/foc/2008/24/6/e7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
✓ Despite recent advances in neuroimaging, differentiation between cerebral abscesses and necrotic tumors with ring-type contrast enhancement can be puzzling at times. The introduction of advanced imaging techniques, such as diffusion-weighted imaging, has contributed to the identification of cerebral abscesses. However, differentiation may be impossible with imaging only. In this review the authors evaluate the role of proton magnetic resonance (MR) spectroscopy in differentiating between cerebral abscesses and necrotic tumors and address the spectral characteristics of intracranial abscesses. A large number of metabolites not detected in the normal brain spectra may be detected and give valuable information regarding the nature of the abscesses. Proton MR spectroscopy is a safe, noninvasive diagnostic modality, which could significantly increase the accuracy and specificity of conventional MR imaging in differentiating between malignant tumors and cerebral abscesses and provide valuable information regarding the cause of an abscess, as well as, its response to the chosen treatment.
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Affiliation(s)
| | - Efstathios D. Gotsis
- 2Encephalos-Euromedica, Advanced Diagnostic and Research Institute, Athens, Greece
| | - Kostas N. Fountas
- 3Neurosurgery, University Hospital of Larissa, University of Thessaly, School of Medicine, Larissa, Greece; and
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Morais LT, Zanardi VDA, Faria AV. Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses. ARQUIVOS DE NEURO-PSIQUIATRIA 2007; 65:1144-8. [DOI: 10.1590/s0004-282x2007000700010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 09/15/2007] [Indexed: 11/21/2022]
Abstract
We report two patients with bacterial brain abscesses whose etiological diagnosis was correctly proposed by association of diffusion weighted images (DWI) and magnetic resonance spectroscopy (MRS) with conventional MRI. Both patients presented ring enhancing lesions with evidences of restricted diffusion. On MRS, the abscess caused by aerobic bacteria presented lactate and aminoacids peaks and the abscess caused by anaerobic facultative bacteria showed also acetate and succinate peaks. These results are in agreement with an unique previous study that related MRS pattern with bacterial etiology. Conventional MRI, associated with DWI and MRS is effective in diagnosing bacterial abscess and promising in exploring its etiology.
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Hagiwara E, Nath J. Choroid plexitis in a case of systemic nocardiosis. Emerg Radiol 2007; 14:337-43. [PMID: 17406912 DOI: 10.1007/s10140-007-0604-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 03/09/2007] [Indexed: 11/27/2022]
Abstract
Although rare, primary choroid plexitis can occur as an early presentation of a central nervous system (CNS) infection most commonly with cryptococcosis, tuberculosis, and nocardiosis. In the appropriate clinical setting, an enlarged, intensely enhancing choroid plexus should raise suspicion for choroid plexitis. It is important to recognize this entity early as aggressive diagnostic and therapeutic intervention may be necessary. We review the existing literature and present a case of infectious choroid plexitis in a patient with systemic nocardiosis; computed tomography and magnetic resonance imaging demonstrated the characteristic findings of choroid plexitis, which later developed into a parenchymal abscess.
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Affiliation(s)
- Eugene Hagiwara
- SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
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